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Vitalia Health Care Patient Intake form

Patient Intake Forms

Before your first visit to Vitalia Health Care, you can download and complete the patient health questionnaire. Please bring it with you.
If you have any questions, please contact us.

General Intake Form (pdf) Download
Autism Intake Form (pdf) Download
Pediatric Intake Form (pdf) Download
Nutrition Intake Form – Adult Download
Nutrition Intake Form – Pediatric Download

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